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Introduction: Dermoscopy of mucosa is known as mucoscopy. Mucoscopy can aid in delineating minute aspects of mucosal lesions and will guide in the differentiation of similar-looking lesions. To date, there are only a few studies on mucoscopy of genital dermatoses especially from India. Aim and Objectives: The study aims to describe mucoscopic features and correlate histopathologically in various genital mucosal diseases. Materials and Methods: The study was conducted in a tertiary care center in Central India after IHEC approval between October 2020 and April 2022, and the sampling technique was based on a convenience purposive method. Any genital mucosal diseases were included in patients above 18 years of age. Sexually transmitted diseases in general were excluded, however, warts and molluscum contagiosum were included. All patients fulfilling the inclusion criteria were examined after proper informed consent, and the clinical images were photographed using iPhone 11. Dermoscopic images were taken using a DermLite DL4 dermoscope in polarized mode at 10X magnification. Results: A total of 206 patients were recruited, and mucoscopy features were analyzed. Dermoscopic findings of physiological conditions such as vestibular papillomatosis, pearly penile papules, and Fordyce spots were evaluated. Inflammatory conditions such as lichen planus, pemphigus, and psoriasis were analyzed. Mucoscopy of lichen sclerosus showed white structureless areas (100%), follicular plugs (35%), as well as dotted and linear vessels (80%). Circinate balanitis revealed regular red dotted vessels (100%), coalescing pustules in annular and polycyclic patterns (90%). Squamous cell carcinoma of the penis showed ulceration, serpentine, looped vessels, white structureless area, and yellow-brown crust in a pink background. Limitations: In our study, because of the inclusion of various diseases, sample size was inadequate, biopsies were not performed in all cases, and variations in mucoscopic features in patients who are already on therapy could not be assessed. Haziness while capturing pictures because of mist formation was hindering the quality of pictures. As patients with premalignant and malignant cases were less, the predicting features for malignant transformation or pathognomoniic signs could not be assessed. Conclusion: Various dermoscopies have been studied extensively, but the mucoscopy is still a gray area. The results of this study revealed the dermoscopic features of various genital disorders and histopathological correlation in few cases. However, biopsy was not performed in all mucosal disorders; hence, conclusive correlation could not be extrapolated.

Introduction: Dermoscopy of mucosa is known as mucoscopy. Mucoscopy can aid in delineating minute aspects of mucosal lesions and will guide in the differentiation of similar-looking lesions. To date, there are only a few studies on mucoscopy of genital dermatoses especially from India. Aim and Objectives: The study aims to describe mucoscopic features and correlate histopathologically in various genital mucosal diseases. Materials and Methods: The study was conducted in a tertiary care center in Central India after IHEC approval between October 2020 and April 2022, and the sampling technique was based on a convenience purposive method. Any genital mucosal diseases were included in patients above 18 years of age. Sexually transmitted diseases in general were excluded, however, warts and molluscum contagiosum were included. All patients fulfilling the inclusion criteria were examined after proper informed consent, and the clinical images were photographed using iPhone 11. Dermoscopic images were taken using a DermLite DL4 dermoscope in polarized mode at 10X magnification. Results: A total of 206 patients were recruited, and mucoscopy features were analyzed. Dermoscopic findings of physiological conditions such as vestibular papillomatosis, pearly penile papules, and Fordyce spots were evaluated. Inflammatory conditions such as lichen planus, pemphigus, and psoriasis were analyzed. Mucoscopy of lichen sclerosus showed white structureless areas (100%), follicular plugs (35%), as well as dotted and linear vessels (80%). Circinate balanitis revealed regular red dotted vessels (100%), coalescing pustules in annular and polycyclic patterns (90%). Squamous cell carcinoma of the penis showed ulceration, serpentine, looped vessels, white structureless area, and yellow-brown crust in a pink background. Limitations: In our study, because of the inclusion of various diseases, sample size was inadequate, biopsies were not performed in all cases, and variations in mucoscopic features in patients who are already on therapy could not be assessed. Haziness while capturing pictures because of mist formation was hindering the quality of pictures. As patients with premalignant and malignant cases were less, the predicting features for malignant transformation or pathognomoniic signs could not be assessed. Conclusion: Various dermoscopies have been studied extensively, but the mucoscopy is still a gray area. The results of this study revealed the dermoscopic features of various genital disorders and histopathological correlation in few cases. However, biopsy was not performed in all mucosal disorders; hence, conclusive correlation could not be extrapolated. [ABSTRACT FROM AUTHOR]

Fordyce spots (FS) are heterotopic sebaceous glands affecting mostly oral and genital mucosa, commonly misdiagnosed with sexually transmitted infections. In a single-center retrospective study, we aimed to assess the ultraviolet-induced fluorescencedermatoscopy (UVFD) clues of Fordyce spots and their common clinical simulants: molluscum contagiosum, penile pearly papules, human papillomavirus warts, genital lichen planus, and genital porokeratosis. Analyzed documentation included patients' medical records (1 September–30 October 2022) and photodocumentation, which included clinical images as well as polarized, non-polarized, and UVFD images. Twelve FS patients were included in the study group and fourteen patients in the control group. A novel and seemingly specific UVFD pattern of FS was described: regularly distributed bright dots over yellowish-greenish clods. Even though, in the majority of instances, the diagnosis of FS does not require more than naked eye examination, UVFD is a fast, easy-to-apply, and low-cost modality that can further increase the diagnostic confidence and rule out selected infectious and non-infectious differential diagnoses if added to conventional dermatoscopic diagnosis. [ABSTRACT FROM AUTHOR]

Background: Clinical differentiation between different cheilitis variants may be difficult. Application of mucoscopy, in addition to clinical background, could provide additional diagnostic clues facilitating initial patient management. Objectives: To determine mucoscopic clues differentiating actinic cheilitis from the main forms of inflammatory cheilitis, including eczematous cheilitis, discoid lupus erythematosus, and lichen planus of the lips. Methods: This was a retrospective, multicenter study being a part of an ongoing project "Mucoscopy – an upcoming tool for oral mucosal disorders" under the aegis of the International Dermoscopy Society. Cases included in the current study were collected via an online call published on the IDS website (www.dermoscopy-ids.org) between January 2019 and December 2020. Results: Whitish-red background was found in actinic cheilitis as well as in cheilitis due to discoid lupus erythematous and lichen planus. Polymorphous vessels were more likely to be seen in actinic cheilitis compared to other causes of cheilitis. White scales, ulceration, and blood spots predominated in actinic cheilitis and lichen planus, whereas yellowish scales typified eczematous and discoid lupus erythematous cheilitis. Radiating white lines although most common in lichen planus patients were also seen in actinic cheilitis. Conclusion: Despite differences in the frequency of mucoscopic structures, we have not found pathognomonic features allowing for differentiation between analyzed variants of cheilitis. [ABSTRACT FROM AUTHOR]

Background: Patients with mucosal lesions form a significant number of routine outpatients presenting to the dermatology department where diagnostic confirmation using histopathological examination of mucosal biopsy is neither feasible nor warranted in every patient. Objective: To study the dermoscopic features of various mucosal lesions affecting the oral cavity and to assess the reliability of mucoscopy vis‑a‑vis clinico‑laboratory findings. Materials and Methods: An observational, cross‑sectional, hospital‑based study was conducted over a period of 2 years from March 2019 to February 2021 in the dermatology outpatient department. Patients presenting with oral mucosal lesions, with or without associated cutaneous involvement, were recruited for mucoscopic evaluation after taking an informed written consent. A detailed history and clinical examination, with emphasis on mucocutaneous examination, was performed and findings were recorded on a standard predesigned proforma. Mucoscopy of oral mucosa was carried out using a handheld dermoscope as well as Universal Serial Bus connected video‑dermoscope in both nonpolarized and polarized modes. The different mucoscopic features were seen at these sites, compared with each other, analyzed and findings were recorded. A diagnosis was made on the basis of mucoscopic findings and correlated with clinical diagnosis. The data was analyzed using appropriate statistical tests. Results: The mean age of patients was 34.3 years and the mean lesional duration was 68.2 weeks. Oral lichen planus (18.66%) was the most common disorder studied, followed by recurrent apthous stomatitis (16.00%), pigmentary lesions (12.66%), vascular disorders (12.00%), mucocele (5.33%), pemphigus vulgaris (4.66%), and discoid lupus erythematosus (4.66%). Conclusion: Dermoscopy in oral lesions facilitates the visualization of the mucosal surface and provides quick confirmation of diagnosis in various mucosal disorders with advanced diagnostic accuracy. Mucoscopy was found helpful in differentiating the oral ulcers, which are a presenting feature of various serious mucocutaneous disorders. Mucoscopy could be a helpful aid in diagnosing pigmented skin lesions and alleviating the apprehension regarding oral melanoma and serve as a screening tool in case of squamous cell carcinoma lips. Limitations: Confirmatory histopathological analysis and correlation with mucoscopic findings could not be established in our study. [ABSTRACT FROM AUTHOR]

Lymphangiomas are benign hamartomatous malformations, infrequently seen in the oral cavity. They can cause aesthetic issues and functional impairments if not treated in the initial stages, thus necessitating the need to diagnose early. Two presentations were observed: a 35‑year‑old male with classical frog‑egg appearance involving lower buccal mucosa with macrocheilia for two years, which was diagnostic on mucoscopy and histopathology, confirming acquired capillary lymphatic malformation. The second case was of a 12‑year‑old girl with a gradual appearance of reddish lesions over the tongue and episodic history of bleeding, which was confirmed on mucoscopy, and histopathology is highlighted. Mucoscopy of both the cases showed yellowish‑pink lacunae with a hypopyon‑like feature and surrounding pale septa. We present two cases of oral lymphangiomas with different presentations and highlight the importance of dermoscopy of oral lesions to bypass invasive techniques such as biopsy. [ABSTRACT FROM AUTHOR]

Introduction: Behçet disease (BD) is an auto-inflammatory condition characterized by multisystemic vasculitis. Oral mucosal capillaroscopy is an easy-to-use, repeatable, non-invasive method for evaluating mucosal microvasculature, contributing to the differential diagnosis and prognosis of various acute and chronic inflammatory diseases. Objectives: This study aims to characterize and describe the oral labial mucosal capillary findings in patients with BD using handheld dermatoscopy and to investigate the relationship between the capillary findings and the severity of the disease. Methods: This cross-sectional study included patients with BD and healthy subjects. Capillaroscopic examination of the oral labial mucosa in each subject was performed by a handheld dermatoscope using polarized light. The clinical severity of BD was evaluated using Krause's Clinical Severity Scoring for BD. Results: Sixty patients with BD and 60 healthy subjects were enrolled in the study. The frequencies of irregular capillaries, microhemorrhages, glomerular vessels, megacapillaries, and tortuous vessels were statistically significantly higher in the patient group when compared to the healthy individuals. In addition, a correlation was detected between the oral mucosal capillaroscopic findings and disease duration, severity, and vascular complications. Conclusions: Our study is the first to explore the potential role of oral mucosal capillaroscopic examination in patients with BD. Data obtained from this study indicated that oral mucosal capillaroscopy may be a useful tool to demonstrate microvascular damage in patients with BD.

The application of a dermoscope in the study of mucosal pathologies is increasingly gaining importance. An easy, noninvasive characterization of pathological changes serves as an aid to dermatologists, sometimes even obliviating the need for histopathology. The aim of the present case series was to describe the mucoscopic features of histologically proven oral leukoplakia. Five consecutive cases of histologically proven oral leukoplakia were included for mucoscopy. Polarized mucoscopy shows white-to-pink structureless areas (100%), intervening pink lines (80%), and surface corrugations (60%). The periphery of the lesions showed white clods (100%) and dotted vessels with irregular arrangement (60%).

Introduction: Chronic graft-versus-host disease (cGvHD) affects around half of allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients, with frequent involvement of the oral mucosa and lip vermillion, that clinically may resemble other autoimmune and inflammatory conditions. Our objectives were to define the dermoscopic patterns of lip vermilion in patients suffering from cGvHD and to compare the presentation with previously published dermoscopic presentations of other disease entities presenting on the lip vermillion. Methods: A group of 16 patients diagnosed with cGvHD was assessed clinically and dermoscopically. The dermoscopic descriptions were made according to recent consensus on terminology of non-neoplastic disorders. Results: Dermoscopy of vermillion frequently revealed dotted vessels that were found in all patients, while linear vessels without bends or branches were seen in 10 of them (62.5%). Peripheral scale, mainly in white color (13/16, 81.2%) was often present. Most striking features were parallel and perpendicular white lines, found in all patients. Other structures included brown dots and blood spots that were present in 10 patients (62.5%). Four patients (25.0%) had blurred vermillion border and in 8 (50.0%) linear fissures or ulceration were found. Typical Wickham striae were found in 3 (18.8%) patients. Conclusions: The dermoscopic features observed in cGvHD affecting lip vermillion warrant differentiation with inflammatory (lichen planus), autoimmune (lichen sclerosus, discoid lupus erythematosus), precancerous (actinic keratosis, leukoplakia), and neoplastic diseases (squamous cell carcinoma), among others. Dermoscopy of lip vermillion might be an additional tool to visualize diagnostic mucoscopic features of cGvHD (lichen planus-like, lichen sclerosus-like lesions). [ABSTRACT FROM AUTHOR]

The article discusses about the diagnosis of oral acute graft-versus-host disease through mucoscopy. Topics of discussion includes mucoscopy is dependent on the clinical picture thorough differential diagnosis including active viral like herpes simplex virus infection, engraftment or Stevens-Johnson syndrome and histopathological examination.

Background: Discoid lupus erythematosus (DLE) may lead to disfiguring scarring and permanent hair loss. Dermoscopy may serve as a noninvasive tool useful in the preliminary diagnosis of hair loss and inflammatory skin diseases. The aim of the paper was to summarize and analyze the dermoscopic features of DLE lesions in various anatomical locations. Methods: A systematic review of PubMed, Scopus and Web of Science was performed using the search terms: 'lupus' OR 'discoid lupus' OR 'cutaneous lupus' combined with 'dermoscopy' OR 'dermatoscopy' OR 'videodermoscopy' OR 'videodermatoscopy' OR 'trichoscopy' OR 'mucoscopy' OR 'onychoscopy'. Results: About 29 out of 318 initially identified papers were included in the analysis. In scalp DLE (n = 166), the most common findings were: white structureless areas (62%), arborizing vessels (57.8%), white scales (54.2%), follicular keratotic plugs (47%), absent follicular openings (45.8%), perifollicular scaling (43.9%), pink‐white background (40.4%), speckled brown pigmentation (38%), and fibrotic white dots (33.7%). In non‐scalp DLE (n = 129), the most frequent features were: follicular keratotic plugs (66.7%), white perifollicular halo (65.9%), white scale (39.5%), speckled brown pigmentation (38.8%), white structureless areas (37.2%), and arborizing vessels (34.9%). There are scarce data in the literature on dermoscopic findings in labial (n = 8), mucosal (n = 3) and ungual DLE (n = 1). Conclusions: DLE is characterized by a wide variety of dermoscopic findings with variable frequencies depending on the location of the lesions. Nevertheless, further studies are needed in order to reliably assess frequencies, correlation with disease stage and significance of individual dermoscopic features. [ABSTRACT FROM AUTHOR]

Background: Diagnosis of oral white lesions might be challenging. These lesions represent a wide spectrum of diseases with different etiology and prognosis. Oral white lesions can be categorized into two major groups, congenital and acquired, according to their development, and in four subgroups: lesions which can be scraped off or not and lesions with special pattern or not. Objectives: The aim of this manuscript is to review, from diagnosis to treatment, the current knowledge on oral white lesions with specific pattern. Methods: A review on oral white lesions with specific pattern was conducted on PubMed and Scopus from inception to January 2021. Results: Among acquired lesions with specific pattern two clinical entities are mostly represented: Oral lichenoid reactions and Lupus erythematosus. The etiology of both diseases is still not known but their pathogenesis is mainly immunological. At present the mucoscopic features of those disease have been described only in few case reports or case series. Immunomodulatory therapies are often the agents of choice for their treatment. Conclusions: The collaboration of dermatologists and dentists as a team is important for early diagnoses and effective treatments. Mucoscopy is a promising technique which may reveal important features for the differentiation of OLP and LE oral white lesions.

Dermoscopy of mucosal surface termed "mucoscopy" is an upcoming offshoot of dermatological imaging. However, the literature on mucoscopy is limited to individual cases and small case series. An organized review or systematic analysis of mucoscopy is lacking. The aim of this review was to summarize the published literature on mucoscopic features of benign conditions affecting the oral mucosa and semi‐mucosa. Additionally, the results of mucoscopic features of diseases, which have not been described before have been presented. [ABSTRACT FROM AUTHOR]

The application of a dermoscope in the study of mucosal pathologies is increasingly gaining importance. An easy, noninvasive characterization of pathological changes serves as an aid to dermatologists, sometimes even obliviating the need for histopathology. The aim of the present case series was to describe the mucoscopic features of histologically proven oral leukoplakia. Five consecutive cases of histologically proven oral leukoplakia were included for mucoscopy. Polarized mucoscopy shows white-to-pink structureless areas (100%), intervening pink lines (80%), and surface corrugations (60%). The periphery of the lesions showed white clods (100%) and dotted vessels with irregular arrangement (60%). [ABSTRACT FROM AUTHOR]

Dermoscopy, a non-invasive technique for cutaneous diagnosis is being increasingly studied in various disorders of the skin, nails and scalp. However, it has been under-utilized for the diagnosis and characterization of mucosal disorders. The dermoscopic characterization of cutaneous lichen planus and its variants has been well documented with Wickham’s striae constituting the hallmark of the condition. However, the dermoscopic features of oral lichen planus with hand-held or videodermoscopy remain to be elucidated. We present the case of a young adult man who presented with asymptomatic white lacy lesions over a bluish-black background over the tongue, patchy hyperpigmentation of the buccal mucosae and gingivae, and longitudinal melanonychia involving some nails. History of intake of any drugs preceding the lesions, smoking, chewing of betel nut and dental implants was negative. Family history was non-contributory. There were no cutaneous lesions suggestive of lichen planus. Mucoscopy (dermoscopy of the mucosa, oral in this case) and onychoscopy were done followed by biopsy from the tongue that confirmed the diagnosis of lichen planus. Oral mucoscopy of the tongue revealed a tri-colored pattern with structureless veil-like grey-white areas (modified Wickham’s striae), well-demarcated red glossy erosions, and violaceous-to-brown clods. Additionally, vascular pattern of dotted and linear to curved vessels along the borders of leukoplakia-like areas and erosions were observed. Onychoscopy confirmed lichen planus-associated melanonychia. Dermoscopy also proved useful in conveniently ruling out other disorders typified by mucosal and nail pigmentation such as Laugier Hunziker syndrome and drug-induced changes. Although direct oral microscopy has been used in defining features of oral lichen planus, to the best of our knowledge this case is the first report on mucoscopy or dermoscopy of oral lichen planus

Dermoscopy, a non-invasive technique for cutaneous diagnosis is being increasingly studied in various disorders of the skin, nails and scalp. However, it has been under-utilized for the diagnosis and characterization of mucosal disorders. The dermoscopic characterization of cutaneous lichen planus and its variants has been well documented with Wickham’s striae constituting the hallmark of the condition. However, the dermoscopic features of oral lichen planus with hand-held or videodermoscopy remain to be elucidated. We present the case of a young adult man who presented with asymptomatic white lacy lesions over a bluish-black background over the tongue, patchy hyperpigmentation of the buccal mucosa and gingivae, and longitudinal melanonychia involving some nails. History of intake of any drugs preceding the lesions, smoking, chewing of betel nut and dental implants was negative. Family history was non-contributory. There were no cutaneous lesions suggestive of lichen planus. Mucoscopy (dermoscopy of the mucosa, oral in this case) and onychoscopy were done followed by biopsy from the tongue that confirmed the diagnosis of lichen planus. Oral mucoscopy of the tongue revealed a tri-colored pattern with structureless veil-like grey-white areas (modified Wickham’s striae), well-demarcated red glossy erosions, and violaceous-to-brown clods. Additionally, vascular pattern of dotted and linear to curved vessels along the borders of leukoplakia-like areas and erosions were observed. Onychoscopy confirmed lichen planus-associated melanonychia. Dermoscopy also proved useful in conveniently ruling out other disorders typified by mucosal and nail pigmentation such as Laugier Hunziker syndrome and drug-induced changes. Although direct oral microscopy has been used in defining features of oral lichen planus, to the best of our knowledge this case is the first report on mucoscopy or dermoscopy of oral lichen planus

Key Clinical Message: Lichen planus (LP) of lip has chances of malignant transformation as it may be exposed to external trauma, smoking, and ultraviolet light. This case highlights the use of dermoscope as a quick noninvasive tool for the diagnosis of LP of lip and monitoring the response to treatment. Lichen planus (LP) of lip has chances of malignant transformation as it may be exposed to external trauma, smoking, and ultraviolet light. This case highlights the use of dermoscope as a quick noninvasive tool for the diagnosis of LP of lip and monitoring the response to treatment. [ABSTRACT FROM AUTHOR]

The scope of dermatoscopy has now vastly expanded and shows promising use for characterization of both pigmentary and inflammatory dermatoses affecting the skin, nail, and mucosae. Due to concerns of contamination and spread of infection, dermatoscopy has not been widely studied for genital mucosal dermatoses. In this article, we review the dermatoscopic features of nonvenereal dermatosis affecting the genitalia. Although biopsy is required for a definitive diagnosis, dermatoscopy is useful to identify atypical and suspicious pigmentary lesions. For the inflammatory dermatoses and other benign dermatoses, presence of few characteristic findings can aid in the diagnosis., Competing Interests: There are no conflicts of interest.

Dermoscopy, a non-invasive technique for cutaneous diagnosis is being increasingly studied in various disorders of the skin, nails and scalp. However, it has been under-utilized for the diagnosis and characterization of mucosal disorders. The dermoscopic characterization of cutaneous lichen planus and its variants has been well documented with Wickham's striae constituting the hallmark of the condition. However, the dermoscopic features of oral lichen planus with hand-held or videodermoscopy remain to be elucidated. We present the case of a young adult man who presented with asymptomatic white lacy lesions over a bluish-black background over the tongue, patchy hyperpigmentation of the buccal mucosa and gingivae, and longitudinal melanonychia involving some nails. History of intake of any drugs preceding the lesions, smoking, chewing of betel nut and dental implants was negative. Family history was non-contributory. There were no cutaneous lesions suggestive of lichen planus. Mucoscopy (dermoscopy of the mucosa, oral in this case) and onychoscopy were done followed by biopsy from the tongue that confirmed the diagnosis of lichen planus. Oral mucoscopy of the tongue revealed a tri-colored pattern with structureless veil-like grey-white areas (modified Wickham's striae), well-demarcated red glossy erosions, and violaceous-to-brown clods. Additionally, vascular pattern of dotted and linear to curved vessels along the borders of leukoplakia-like areas and erosions were observed. Onychoscopy confirmed lichen planus-associated melanonychia. Dermoscopy also proved useful in conveniently ruling out other disorders typified by mucosal and nail pigmentation such as Laugier Hunziker syndrome and drug-induced changes. Although direct oral microscopy has been used in defining features of oral lichen planus, to the best of our knowledge this case is the first report on mucoscopy or dermoscopy of oral lichen planus., Competing Interests: No competing interests were disclosed.

Competing Interests: Competing interests: The authors have no conflicts of interest to disclose.